Project Summary for Electronic Long-Term Services and Supports (eLTSS) Service Plan (Jira PSS-2235)
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Project Details
Number | 1431 View Ballot Items List (with NIBs) |
---|---|
Name | Electronic Long-Term Services and Supports (eLTSS) Service Plan (Jira PSS-2235) |
Sponsor(s) | Human and Social Services Work Group |
Co-Sponsor(s) | Community-Based Care and Privacy (CBCP) Work Group |
Steering Division | N/A |
Description | Brief Overview: The eLTSS FHIR Implementation guide was previously published as STU1 in 2019. There are deferred JIRA issues, a new, additional, Pilot implementation and an ONC sponsored IG development effort. This PSS covers updating the eLTSS FHIR IG as an ONC funded project.
This next phase of the project is to: Update the eLTSS FHIR IG based on the learnings and feedback from the Missouri DMH pilot implementation and stakeholders in the HL7 standards development community. The electronic Long-Term Services and Supports (eLTSS) FHIR Implementation Guide (IG) was developed to support exchange of data generated during the planning and provision of long-term services and supports. HL7 published an STU version 1.0.0 in 2019. In 2020, the Office of the National Coordinator for Health IT (ONC) awarded a cooperative agreement to the Missouri Department of Mental Health (DMH), Division of Developmental Disabilities as part of the Leading Edge Acceleration Project (LEAP) program. Under the cooperative agreement, the Missouri DMH supported testing and implementation of the eLTSS IG for exchange of Missouri Individual Service Plan information across provider IT systems. Tasks include, but are not limited to, the following: Evaluate lessons learned and feedback from stakeholders to inform content updates to the IG: - Sources of feedback should include, The Office of the National Coordinator for Health Information Technology (ONC), Missouri DMH, HL7 Community-based Care & Privacy (CBCP) Workgroup, and Human and HL7 Social Services (HSS) Workgroup. Work with the Gravity Project to align with the Gravity SDOH Clinical Care IG. § Review the SDOH Clinical Care IG for profiles intended for similar use case and align where appropriate - Review Gravity value sets and how they are used in US Core profiles (in version 5.0.1 or later) for SDOH content to determine if these profiles and/or the model of value set usage can be incorporated into the eLTSS approach. - Address any known issues with the IG, including those documented in HL7’s Jira: o Propose resolutions to any outstanding Jira trackers and apply changes to the IG as appropriate. Consider replacing the use of CarePlan.activity.detail (which is intended for inline simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources and, instead, using referencing resources (e.g. procedure orders) already existing in the health systemEvaluate any Jira trackers marked “consider for future use” and develop/update IG content as appropriate. - Update the content of the eLTSS FHIR IG for a subsequent version update. o Update content to align with US Core v3.1.1 or a more recent version, if it becomes appropriate during the projectDetermine publication pathway for an IG version update, e.g. un-balloted STU update or STU ballot (see: https://confluence.hl7.org/pages/viewpage.action?pageId=107217093) - Facilitate testing of updated content as prerequisite to version update:Coordinate with Missouri DMH to determine appropriate testing venue, i.e. HL7 FHIR Connectathon or other standalone testing event (as approved by the HL7 FHIR Management Group).Provide administrative support for testing event, including: define objectives, develop presentations and other documentation to support participants, facilitate HL7 processes for testing event (e.g. obtain necessary approvals, submit content according to HL7 deadlines, etc.), participate in testing event to ensure participants achieve goals and objects, prepare summary of results, etc.Update the eLTSS FHIR IG as appropriate based on findings from testing event. · Facilitate balloting and ballot reconciliation (if needed) - Facilitate publication of updated eLTSS FHIR IG The original scope of this project was the following: The electronic Long-Term Services and Supports (eLTSS) Initiative, a joint project between the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC), initiated in late 2014 as one of the four components of the Medicaid testing Experience and Functional Tools (TEFT) demonstration grant program. The project’s aim is to advance data-level interoperability for the Home and Community-Based Services (HCBS community) and to facilitate the identification and validation of a data standard for capturing and exchanging person-centered LTSS service plan data. The primary objectives of the eLTSS Initiative are: 1) To identify components or data elements needed for the electronic creation and interoperable exchange of person-centered service plans by health care and HCBS providers, payers and the individuals they serve; and 2) To field test these data elements within and across participating organizations’ electronic systems. The Primary Products of the eLTSS Initiative to-date are: 1. eLTSS Dataset Published - September 2017 Collaborative requirements gathering and harmonization efforts have culminated into the publication of the eLTSS dataset and supporting documentation (e.g. use cases, etc.). The eLTSS dataset contains data items commonly found on LTSS Service Plans and serves as the groundwork for developing electronic means for exchanging LTSS data. 2. Initial implementer guidance (eLTSS Informative Document) - balloted by HL7 in September 2018, submitted for publication The eLTSS Informative document serves as the initial technical guidance for leveraging FHIR and C-CDA Health IT Standards for exchanging eLTSS Dataset data items. It served to introduce LTSS perspectives to the HL7 community and may be used to support electronic piloting efforts by LTSS solution implementers. The next phase of the project is to develop: 3. eLTSS FHIR Implementation Guide - planned to be balloted in May 2019 The eLTSS FHIR Implementation Guide is under development and is projected to be included in t... |
Project Facilitator | Bret Heale |
Status | STU - Test Period/Accepting Comments |
SD Approval Date | Jul 15, 2018 |
TSC Approval Date | Aug 15, 2018 |
Type | Ballot - Informative |
Objectives / Deliverables | FHIR IG STU2 Update: Target STU ballot in January 2024 cycle. Publish Whitepaper outlining informal implementer guidance for the LTSS community on how to leverage FHIR and C-CDA to exchange LTSS Dataset data. Included will be 1. Detailed mapping of eLTSS Dataset to FHIR 2. Detailed mapping of eLTSS Dataset to C-CDA - Target: Aug 2018 Whitepaper to be balloted during September 2018 balloting cycle On an as needed basis: Submit proposed FHIR changes to better accommodate representation of eLTSS Dataset Information via FHIR Resources By May 2018 Mature the eLTSS Whitepaper into a draft Implementation Guide - Target: By May 2019 Project End Date - Sept 2020 |
Next Milestone Date | 2027 September WGM |
Project End Date | 2027 September WGM |
Project Intent | Implementation Guide |
Project Need | The “electronic Long-Term Services and Supports Plan Use Case” [1] describes the eLTSS service plan “is intended to be shared electronically, with beneficiary approval, across multiple HCBS settings (e.g., the homes of beneficiaries receiving services, adult day services, schools, group homes, foster homes, assisted living, employment sites, supportive housing, home health, and hospice), institutional settings (e.g. hospitals, nursing facilities, primary care, post-acute care) and with individuals receiving services and payers.” The settings and entities identified in the eLTSS Use Case employ several electronic information systems such as EHRs, State Medicaid Agency systems (e.g. Medicaid Management Information System (MMIS), waiver case management systems, etc.), Health Information Exchange (HIE) systems, Personal Health Record (PHR) systems, and other information systems (e.g. service provider systems) to collect and store data. Few, if any, of these systems can currently interface with each other and exchange LTSS service plan data electronically. One of the challenges in integrating this data with disparate health systems is the lack of an agreed-upon data standard for representing and exchanging such data. The standardization of the eLTSS Dataset supports a broader vision for integrating person-centered planning data elements into technologies currently available to support the health and wellness of individuals and the sharing of this information across disparate users and systems. These emerging technologies are commonly referred to as ‘smart technologies’ that can be applied to not just the clinical part of healthcare, but to the larger care continuum and perhaps most promisingly to State Medicaid programs. Given the size, scope, and cost of the Medicaid programs, federal and state governments have an opportunity to leverage these smart technologies to improve health outcomes for Medicaid members, to achieve greater program efficiencies and to expand the notion of “care” to more than just a clinical episode. [1] https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/eLTSS+Use+Case+Development+and+Functional+Requirements Additional: The eLTSS FHIR Implementation guide was previously published as STU1. There are deferred JIRA issues, a new Pilot implementation and an ONC sponsored IG development effort. This PSS covers updating the eLTSS FHIR IG as an ONC funded project. |
Implementers | CMS, ONC SAMHSA Missouri Department of Mental Health (DMH), Division of Developmental Disabilities |
Security Risks | No |
External Drivers | Office of the National Coordinator for Health Information Technology (ONC) which is providing funding. The STU1 version of the eLTSS IG was published Georgia (Georgia Department of Community Health, supported by Georgia Tech) team’s participation in this effort is slated to end at the conclusion of (including any no-cost extensions) Georgia’s participation under the Testing Experience and Functional Tools (TEFT) Demonstration Grant funded by CMS. Currently that date is projected to be March 31st 2019. |
Common Names / Keywords/ Aliases | eLTSS – electronic Long-Term Services and Supports HCBS – Home and Community Based Services |
Lineage | |
Dependancies | None for the STU2 update. https://gforge.hl7.org/gf/project/cbcc/docman/eLTSS%20-%20%20ONC%20Electronic%20Long-Term%20Services%20and%20Supports/ Additional Project Background Available Here: https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/eLTSS+Home |
Project Document Repository |
https://github.com/HL7/eLTSS PSS: https://jira.hl7.org/browse/PSS-2235?src=confmacro |
Backwards Compatibility | Yes |
External Vocabularies | N/A |
Products | FHIR Implementation Guide |
Joint Copyright? | No |
External Pjt Collaborators | The LTSS Dataset has been developed and published in August 2017. The whitepaper containing implementer guidance on using HL7 standards (e.g. FHIR and C-CDA) is currently being drafted under CBCP guidance. The LTSS Dataset was developed externally and published under ONC leadership. The whitepaper is being drafted under guidance of CBCP co-chairs and membership. |
Realm | Realm Specific - Enter "U.S." or name of HL7 Affiliate below |
HL7 Affiliate | U.S. |
Stakeholders | Regulatory Agency, Payors |
Vendors | EHR, PHR; Health Care IT |
Providers | Clinical and Public Health Laboratories; Emergency Services; Local and State Departments of Health; Medical Imaging Service; Healthcare Institutions (hospitals, long term care, home care, mental health); Other (specify in Misc. Notes below) |
Ballot Cycle Info | 2019 May Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 3 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm 2018 Oct Ballot Cycle Info: INFORMATIVE Ballot results: Met basic vote requirements. 4 Negatives to reconcile Document Name: HL7 Cross-Paradigm Guidance: Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm |
Misc Notes | 2023 June: PSS Updated for STU2 FHIR IG. 2022 May: TSC approved STU Extension Request for Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm for 5 years 2022 Jan: TSC approved STU extension request for Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm 2019 Jan: TSC approved Informative Publication Request for HL7 Cross-Paradigm Information Sharing for Electronic Long-Term Services and Supports (eLTSS), Release 1. PMO archiving. 2018 October: Updated PSS as follows: Mature the eLTSS Whitepaper into a draft Implementation Guide - Target: By Jan 2019 |
U.S. Govt Interest? | Yes |
USRSC Approval | Received |
FMG Approval | All Received |
ARB Approval | Not Needed |
Start Date | Jul 2, 2018 |
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